title: Outcomes following resection of intramedullary spinal cord cavernous malformations: a 25-year experience.
abstract: OBJECTIVE
  The management of intramedullary spinal cord cavernous malformations (CMs) is controversial. At Barrow Neurological Institute, the authors selectively offer surgical treatment for symptomatic spinal cord CMs. The purpose of this paper is to review the clinical outcomes in patients after resection of these lesions based on a single-center experience over a 25-year period.
  
  
  METHODS
  The records of 80 patients who underwent resection of pathologically confirmed spinal cord CMs from January 1985 to May 2010 were analyzed retrospectively. Preoperative clinical status and imaging findings were evaluated as well as immediate and long-term postoperative outcomes.
  
  
  RESULTS
  Compared with their preoperative Frankel grade, 11% of patients were worse, 83% were the same, and 6% improved immediately after surgery. At a mean follow-up interval of 5 years, 10% of patients were worse, 68% were the same, and 23% were improved compared with their preoperative status. Five percent of patients underwent reoperation for resection of a symptomatic residual or recurrent lesion. Immediate complications were encountered in 6% of patients, including CSF leakage and deep venous thrombosis. Long-term complications were encountered in 14% of patients and included kyphotic deformity, stenosis, and spinal cord tethering. A significant correlation was found between long-term outcome and anteroposterior length of the lesion (p = 0.01).
  
  
  CONCLUSIONS
  The resection of intramedullary spinal cord CMs can be achieved with good long-term outcomes and an acceptable risk of immediate or delayed complications.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
authors.forename: Alim P
authors.initials: AP
authors.lastname: Mitha
authors.forename: Jay D
authors.initials: JD
authors.lastname: Turner
authors.forename: Adib A
authors.initials: AA
authors.lastname: Abla
authors.forename: A Giancarlo
authors.initials: AG
authors.lastname: Vishteh
authors.forename: Robert F
authors.initials: RF
authors.lastname: Spetzler
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000792:Angiography; D001165:Arteriovenous Malformations / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications; D013116:Spinal Cord / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology; D013118:Spinal Cord Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome